Carpal-tunnel surgery brings relief to Great Falls hairdresser

3:07 PM,
Jun. 30, 2011

Kathy Fleming of Hair Dimensions takes a break while working on her sister’s hair, Christi Pilcher. Flemming had surgery in 2009 to fix the carpal tunnel syndrome she was suffering from. / PHOTO by RION SANDERS

Written by

Tribune Staff Writer

The Great Falls hair dresser’s symptoms were the worst at night, and sometimes they’d keep her from sleeping — the result of carpal tunnel syndrome.

Fleming had surgery in 2009 to correct the condition. Since then the symptoms have disappeared entirely.

“That night, I slept all night after the surgery,” she said. “It was amazing.”

Carpal tunnel syndrome is caused when the median nerve, which runs from the arm to the hand, is compressed, said Dr. Alexander Chung, orthopedic surgeon with Great Falls Orthopedic Associates.

The nerve passes through the carpal canal or carpal tunnel, where it is surrounded by bone, tendons and ligaments. When there’s swelling in the canal, the nerve becomes squished, making the fingers and hand feel numb, tingly and painful.

“The whole issue here is that the nerve gets compressed,” Chung said.

Some people just naturally have a smaller carpal canal, making carpal tunnel syndrome more likely. Carpal tunnel syndrome also can be caused by other condition such as thyroid imbalances, diabetes, arthritis and metabolic diseases.

Pregnancy also increases the risk of carpal tunnel syndrome because the fluid retention experienced during pregnancy can lead to increased pressure on the median nerve. Injury also can increase the chance of developing the condition.

The myth

“There’s no evidence to suggest (carpal tunnel syndrome) is work related,” Chung said.

(Occupations that cause repetitive trauma to the wrists, such as jackhammering, are an exception.)

One 1970s study showed that carpal tunnel syndrome was caused by repetitive motion such as keyboarding. No other study has been able to replicate those findings and there has been a misconception that office work leads to carpal tunnel syndrome ever since, Chung said.

“If it’s true that keyboarding is the main cause of carpal tunnel, 99 percent of us should have it,” he said.

Instead, carpal tunnel syndrome occurs in about 11 percent of women and less than 4 percent of men, assuming a life expectancy of 70 years. It’s most common in people older than 40.

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Most patients experience pain, tingling and numbness in their hand, index, middle and ring fingers. For many people, it feels like a limb that’s gone to sleep. The symptoms are usually worse at night and keep many patients awake, Chung said.

Sharp pain or soreness in the forearm are typically caused by something other than carpal tunnel syndrome.

The syndrome is diagnosed using an electrical nerve conduction test, Chung said.

If a patient has a mild condition, Chung recommends wearing splints at night. When we sleep, we curl our fists in, bending the wrists and further restricting the median nerve. Wearing a splint can help. Patients might also opt for cortisone injections, which decreases the swelling that might cause the nerve to be constricted.

For severe conditions, Chung recommends surgery. The surgery is relatively simple, quick and has few complications.

The palm side of the carpal canal is made up of a ligament. In surgery, that ligament— which actually doesn’t serve a purpose—is cut, allowing more room for the median nerve.

The outpatient surgery takes about 15 minutes. The incision is only about an inch and a half long. Most patients report immediate relief after the surgery and recovery is quick.

It’s important to see a doctor sooner rather than later if someone suspects they have carpal tunnel syndrome, as it can cause irreversible nerve damage. The median nerve often suffers permanent damage in those who have had severe carpal tunnel syndrome for decades. Surgery will help prevent symptoms from getting worse, but may not cure the tingling and numbness.